Billing Coding Specialist (59138)

Summary of Position:

The Billing Coding Specialist is primarily responsible for the coding/billing, and resolution of denied claims.

Essential Duties:

Duties include, but are not limited to:

• Code claims according to coding and billing guidelines.
• Bill claims in accordance with payor guidelines.
• Investigate payer- rejected claims to determine reason for denial and work to obtain resolution.
• Prioritize and work HOLD an MGR HOLD buckets.
• Verify patient insurance coverage and eligibility.
• Update patient records with accurate insurance information.
• Manage accounts receivable and follow up on overdue payments.
• Collaborate with other departments, such as medical coding and front office, to ensure accurate and timely processes.
• Support the revenue cycle by ensuring clai8ms are dropped within 2 days of current date.
• Assist in general administrative tasks as needed.
• Review all claims returned for Medical Necessity and correct if able; report findings to Team Lead.
• Follows established departmental policies, procedures, and objectives, continuous quality improvement objectives, and safety and environmental standards.
• Attends coding conferences, workshops, and in-house sessions to receive updated coding information and changes in coding and/or regulations.
• Performs other duties as required.
• Other Duties as presented by supervisor and/or Directors.